• Sarthak Sinha, Caleb Small, Eddie Guo, Myriam Verly, Rohit Arora, Aydin Herik, Eva Lindell Jonsson, A Robertson Harrop, Jeff Biernaskie, Claire Temple-Oberle, and Vincent Gabriel.
• Leaders in Medicine Program, Cumming School of Medicine, University of Calgary, Canada; Faculty of Veterinary Medicine, University of Calgary, Canada; Department of Clinical Neurosciences, University of Calgary, Canada.
• Burns. 2024 Sep 2; 51 (1): 107258107258.

ObjectiveTo identify burn patients needing intensive rehabilitation based on discharge symptoms.MethodsWe conducted a retrospective analysis of 1049 adult burn patients recruited to the Burn Injury Model System National Database. Using unsupervised hierarchical clustering, we identified three distinct patient clusters based on discharge symptoms and compared their clinical and demographic profiles, long-term rehabilitative needs, and self-reported quality of life. We also developed a weighted BUrn Rehabilitative Needs - OutPatient (BURN-OP) to prospectively identify patients with highest rehabilitative needs.ResultsThree burn patient clusters were identified: Cluster 1 with low, Cluster 2 with moderate, and Cluster 3 with high symptom burdens. Cluster 3, comprising 6 % of discharged patients, had notably longer hospital stays, older age at burn, larger total body surface area (TBSA), increased days on ventilator, a higher number of surgical procedures, concomitant inhalation injury, and higher weight loss from admission to discharge. Cluster 3 patients preferentially utilized a wide spectrum of rehabilitative services (including physiotherapy, occupational therapy, speech-language pathology, social work, psychologic services, vocational services) extending up to 2 years post-discharge. Their self-reported health outcomes were worse, with greater limitations in work/activity and elevated pain interference persisting 5-years post-discharge. BURN-OP demonstrated high specificity (98.99 %) and accuracy (96.19 %, ROC AUC: 0.93) in identifying Cluster 3 patients at discharge.ConclusionsWe identify distinct burn patient clusters based on discharge symptoms, with Cluster 3 exhibiting the highest post-discharge healthcare needs. BURN-OP (https://burn-op.streamlit.app/) identifies high-risk patients, offering a tool for prioritizing interventions and designing trials that mitigate risk of Cluster 3 membership.Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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